Falls Risk Prevention – [Updated 2022]
Falls Can Change Your Life Forever
Falls - The Facts
A fall is defined as having an unexpected event in which the person comes to rest on the ground.
Falls are the leading cause of injury-related hospital admission in people aged 65 years and older.
At least one third of community dwelling older adults fall each year.
The Australian population aged 65 and over is projected to increase from 13% in 2010 to 24% by 2050.
The fastest growing population group is those aged 85 years and older.
Anxiety and fear of falling is a significant consequence after falls which leads to loss of confidence, restricted activity and social isolation.
Important: With Falls Risk, we are only a part of the overall picture. You should also talk to your family doctor, your physiotherapist and your nurse or occupational therapist to give yourself the best chance os having a fall.
What Increases Your Falls Risk?
It’s not surprising that age is one of the biggest risk factors when it comes to falls.
But why do we become more at risk as we age? And what other factors are at play?
Eyesight:
It makes sense that as our eyesight diminishes, our falls risk increases.
If we can’t see changes in the surface we are walking on, things like different angles, lips into doorways,small objects or fluids can all be terrible risk factors.
Hearing:
- Hearing loss has a complex affect on falls risk.
Zhanneta Shapiro wrote in ASHA Wire – Leader Live that there are three factors that may cause hearing loss to increase falls risk:
“Hearing loss makes people less aware of their environment, so they don’t notice other people, pets or activities going on around them.
In addition, hearing loss can decrease spatial awareness, so being able to gauge where their body is in relation to objects around them gets trickier.
Finally, hearing loss causes the brain to use more resources for hearing and interpreting speech and sound, so fewer resources go toward gait or balance. These factors can all make patients with hearing loss more likely to lose their balance and fall.”
You can read her full article here.
Vestibular Balance Disorders:
There are many causes of Vestibular Balance Disorders including:
- Medicines
- Infections
- Inner ear problems, such as poor circulation in the ear
- Calcium debris in your semicircular canals
- Problems rooted in your brain, such as traumatic brain injury
Postural Hypotension:
As we age our bodies don’t regulate our blood pressure as well as they used to.
As we stand up, gravity causes our blood pressure to fall as the blood heads to our legs, if our bodies don’t quickly compensate for the loss in pressure by constricting the blood vessles, we we will feel dizzy and possibly pass out due to less blood pressure in the brain.
Muscle Weakness:
It’s quite obvious to most people who are 50 or over that muscle mass is harder to keep up, and we are usually not as strong as we used to be when we were in our 20s or 30s.
We rely on strong muscles throughout our back, pelvis, legs and feet to remain upright when walking. As these muscles start to lose some of their strength we don’t tend to notice in day to day living.
It’s only usually when something else throws us off like a crack in the footpath, uneven surface or we get bumped that it suddenly becomes a problem as we are unable to use those muscles to adjust quickly enough to prevent ourselves from falling.
Peripheral Neuropathy:
We see patients with peripheral neuropathy every day in our clinic.
Peripheral neuropathy is a lack of sensation in the hands and/or feet.
When it occurs in the feet people report the following sensations:
- numbness,
- pain,
- tingling, burning, pins and needles,
- a feeling that they are standing on something soft like cardboard or little pillows
Peripheral neuropathy significantly increase the risk of falls as there is much less feedback from the feet to the brain about what is happening under foot (proprioception).
The most common causes of peripheral neuropathy are:
- poorly controlled diabetes,
- some chemotherapies,
- malnutrition,
- age.
To find out more about how Diabetes affects the feet read here.
Arthritis:
All forms of arthritis including osteo, rhumatoid, psoriatic, and reactive arthritis can increase your falls risk.
As the cartilage is damaged by arthritis it is usually damaged unevenly. This causes knees and hips to change the angle that they move through.
The changes in direction upsets your balance and can make you more likely to fall. Especially on uneven surfaces.
You can read more about how arthritis affects the feet and ankles here.
Medications
There are many medications which can increase your falls risk.
Medications to control hypertension (high blood pressure) can cause you to have a sudden drop in blood pressure as you stand up. This can make you dizzy and at risk of falling.
Other medications for pain and other ailments can also increase your falls risk. Check with your doctor or pharmacist to see if your medications increase your risk of falling.
How can a podiatrist help?
A podiatrist role should involve a screening for ill-fitting or inappropriate footwear, foot pain and other foot problems as these are risk factors for falls.
Other risk factors for falls include: increased age, previous history of falls, chronic medical condition, impaired balance and mobility, reduced muscle strength and sensory problems (peripheral neuropathy, vision).
How We Can Help
- Performance-based falls screening testing that helps determine your risk of falls.
- Footwear assessment and education.
- Podiatry care addressing foot related problems.
What footwear features you should look for to reduce the risk of falls?
– Soles: thinner and firmer soles improve foot position sense
– Heels: a low, square bevelled heel improves stability
– Upper: shoes with a supporting upper around the ankle improve stability.
Interventions must be a multifactorial management team approach with allied health professionals to be successful.
A podiatrist should be able to assess your risk of falls doing a history, assessment and performance-based falls screening test.
They can help manage your risk of falls through addressing foot pain, other foot problems (callus, corns), strengthening exercises and footwear.
Strategies to Reduce Falls Risk
There are some strategies that we can give you to help reduce your risk of having a fall.
- Making sure that there are not things on the floors, especially the main areas where you walk.
- Having shoes and socks every time you leave the house, but also when you are in the house if you are quite unsteady.
- Having railings in areas like bathrooms and toilets as well as shower seats and higher toilet seats are appliances which are very important in reducing the likelihood of a fall.
- If you have been advised by your doctor or therapist to use a walking aide, make sure that you always have it with you. Falls often happen when people aren’t using the appliances recommended for them. Don’t think, “I’ll only be out for a moment,” it could be a decision you regret. Whether it’s a walking stick, a crutch, or a wheelie walker, they are used by many people and they significantly reduce falls risks.
At Dynamic Podiatry our promise to you is to do all we can to keep you active and on your feet.
Remember: With Falls Risk, we are only a part of the overall picture. You should also talk to your family doctor, your physiotherapist and your nurse or occupational therapist to give yourself the best chance os having a fall.
We have the experience and the tools to analyse your falls risk and minimise it from a foot and ankle point of view.
To make an appointment with the podiatry team at Dynamic Podiatry to help prevent falls from occurring call 3351 8878 or click the button below to book online.
